Department of Neurology, NYU School of Medicine, Multiple Sclerosis Care Center, New York, NY 10003-3804, USA.
Neurology. 2010 Jul 20;75(3):217-23. doi: 10.1212/WNL.0b013e3181e8e72a.
To investigate utility of a Multiple Sclerosis Severity Scale (MSSS)-based classification system for comparing African American (AA) and white American (WA) multiple sclerosis (MS) subpopulations in the New York State Multiple Sclerosis Consortium (NYSMSC) database. MSSS is a frequency-rank algorithm relating MS disability to disease duration in a large, untreated reference population. Design/
Distributions of patients in 6 MSSS-based severity grades were calculated for AA and WA registrants.
There were 419 AA and 5,809 WA patients in the NYSMSC, who had EDSS recorded during years 1-30 since symptom onset. Median EDSS was not different in AA and WA (3.5 vs 3.0, p = 0.60), whereas median MSSS in AA was higher than in WA (6.0 vs 4.8, p = 0.001). AA patients were overrepresented in the 2 most severe grades (41.5% vs 29.3% for WA) and underrepresented in the 2 lowest grades (23.4% vs 35.4%; p < 0.001). In multivariable analysis (ordered logistic and median regression), MSSS for AA remained significantly higher than in WA after adjusting for age, gender, disease duration, disease type distribution, and treatment with disease-modifying therapies.
The 6-tiered MSSS grading system is a powerful tool for comparing rate of disease progression in subpopulations of interest. MSSS-based analysis demonstrates that African ancestry is a risk factor for a more rapidly disabling disease course.
研究基于多发性硬化严重程度量表（MSSS）的分类系统在纽约州多发性硬化协会（NYSMSC）数据库中比较非裔美国人和白人美国人多发性硬化亚群的效用。MSSS 是一种频率-等级算法，将 MS 残疾与未经治疗的大参考人群中的疾病持续时间相关联。设计/方法：计算了 6 个 MSSS 严重程度等级中 AA 和 WA 登记患者的分布。结果：NYSMSC 中有 419 名 AA 和 5809 名 WA 患者，他们在发病后 1-30 年内记录了 EDSS。AA 和 WA 的中位 EDSS 无差异（3.5 与 3.0，p=0.60），而 AA 的中位 MSSS 高于 WA（6.0 与 4.8，p=0.001）。AA 患者在 2 个最严重的等级中占比过高（41.5%比 WA 中的 29.3%），在 2 个最低的等级中占比过低（23.4%比 WA 中的 35.4%；p<0.001）。在多变量分析（有序逻辑回归和中位数回归）中，在调整年龄、性别、疾病持续时间、疾病类型分布和疾病修饰疗法治疗后，AA 的 MSSS 仍显著高于 WA。结论：6 级 MSSS 分级系统是比较感兴趣的亚群中疾病进展率的有力工具。基于 MSSS 的分析表明，非洲血统是疾病进展更快导致残疾的危险因素。
